Journal article
International Survey of Transfusion Practices for Extremely Premature Infants
Seminars in perinatology, Vol.36(4), pp.244-247
08/2012
DOI: 10.1053/j.semperi.2012.04.004
PMCID: PMC3579510
PMID: 22818544
Abstract
Our objective was to survey neonatologists regarding international practice of red cell transfusion thresholds for premature infants with <1000-g birth weight and/or <28-week gestation. An invitation to fill out an 11-question web-based survey was distributed to neonatologists through their professional societies in 22 countries. Physicians were asked about which specific factors, in addition to hemoglobin levels, influenced their decisions about transfusing premature infants. These factors included gestational age, postnatal age, oxygen need, respiratory support, reticulocyte count, and inotropic support. Physicians were presented with 5 scenarios and asked to identify hemoglobin cutoff values for transfusing infants with <1000-g birth weight and/or <28-week gestation. One thousand eighteen neonatologists responded: the majority were from the United States (67.5%), followed by Germany (10.7%), Japan (8.0%), the United Kingdom (4.9%), Spain (3.9%), Italy (2.6%), Colombia (0.6%), Argentina (0.4%), Canada (0.4%), Belgium (0.1%), and the Netherlands (0.1%). Half of the respondents (51.1%) reported having a written policy with specific red cell transfusion guidelines in their unit. Factors considered “very important” regarding the need to administer blood transfusions included degree of oxygen requirement (44.7%) and need for respiratory support (44.1%). Erythropoietin was routinely used to treat anemia by 26.0% of respondents. Delayed cord clamping or cord milking was practiced by 29.1% of respondents. The main finding was of a wide variation in the hemoglobin values used to transfuse infants, regardless of postnatal age. Step-wise increments in the median hemoglobin cutoffs directly paralleled an increase in the need for levels of respiratory support. In the first week of life, there was a wider range in the distribution of hemoglobin transfusion thresholds for infants requiring no respiratory support and full mechanical ventilation compared with the thresholds used in the second, third, and fourth weeks of life. An international survey using hypothetical scenarios shows that red blood cell transfusion practices vary widely among practicing neonatologists in participating countries.
Details
- Title: Subtitle
- International Survey of Transfusion Practices for Extremely Premature Infants
- Creators
- Úrsula Guillén - Section of Neonatology, Christiana Care Health System, Newark, DEJames J Cummings - Division of Neonatology, East Carolina University, Greenville, NCEdward F Bell - Department of Pediatrics, University of Iowa, Iowa City, IAShigerharu Hosono - Division of Neonatology, Nihon University School of Medicine, Tokyo, JapanAxel R Frantz - Department of Pediatrics and Center for Pediatric Clinical Studies, University of Tübingen, Tübingen, GermanyRolf F Maier - Department of Pediatrics, Philipps University of Marburg, Marburg, GermanyRobin K Whyte - Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, CanadaElaine Boyle - Department of Pediatrics, University of Leicester, Leicester, UKMax Vento - Division of Neonatology, Hospital Universitario Materno-Infantil La Fe, Valencia, SpainJohn A Widness - Department of Pediatrics, University of Iowa, Iowa City, IAHaresh Kirpalani - Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA
- Resource Type
- Journal article
- Publication Details
- Seminars in perinatology, Vol.36(4), pp.244-247
- DOI
- 10.1053/j.semperi.2012.04.004
- PMID
- 22818544
- PMCID
- PMC3579510
- NLM abbreviation
- Semin Perinatol
- ISSN
- 0146-0005
- eISSN
- 1558-075X
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 08/2012
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984093493602771
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